title: Sustained life-like waveform capnography after human cadaveric tracheal intubation.
abstract: BACKGROUND
  Fresh frozen cadavers are effective training models for airway management. We hypothesised that residual carbon dioxide (CO2) in cadaveric lung would be detectable using standard clinical monitoring systems, facilitating detection of tracheal tube placement and further enhancing the fidelity of clinical simulation using a cadaveric model.
  
  
  METHODS
  The tracheas of two fresh frozen unembalmed cadavers were intubated via direct laryngoscopy. Each tracheal tube was connected to a self-inflating bag and a sidestream CO2 detector. The capnograph display was observed and recorded in high-definition video. The cadavers were hand-ventilated with room air until the capnometer reached zero or the waveform approached baseline.
  
  
  RESULTS
  A clear capnographic waveform was produced in both cadavers on the first postintubation expiration, simulating the appearances found in the clinical setting. In cadaver one, a consistent capnographic waveform was produced lasting over 100 s. Maximal end-tidal CO2 was 8.5 kPa (65 mm Hg). In cadaver two, a consistent capnographic waveform was produced lasting over 50 s. Maximal end-tidal CO2 was 5.9 kPa (45 mm Hg).
  
  
  CONCLUSIONS
  We believe this to be the first work to describe and quantify detectable end-tidal capnography in human cadavers. We have demonstrated that tracheal intubation of fresh frozen cadavers can be confirmed by life-like waveform capnography. This requires further validation in a larger sample size.
authors.affiliation: Department of Ambulance Service New South Wales, Greater Sydney Area Helicopter Emergency Medical Service, Bankstown, New South Wales, Australia.
authors.forename: Cliff
authors.initials: C
authors.lastname: Reid
authors.affiliation: Department of Ambulance Service New South Wales, Greater Sydney Area Helicopter Emergency Medical Service, Bankstown, New South Wales, Australia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Lewis
authors.affiliation: Department of Ambulance Service New South Wales, Greater Sydney Area Helicopter Emergency Medical Service, Bankstown, New South Wales, Australia.
authors.forename: Karel
authors.initials: K
authors.lastname: Habig
authors.affiliation: Department of Ambulance Service New South Wales, Greater Sydney Area Helicopter Emergency Medical Service, Bankstown, New South Wales, Australia.
authors.forename: Brian
authors.initials: B
authors.lastname: Burns
authors.affiliation: Sydney Hospital Macquarie Street, Sydney, New South Wales, Australia.
authors.forename: Frank
authors.initials: F
authors.lastname: Billson
authors.affiliation: Sydney Hospital Macquarie Street, Sydney, New South Wales, Australia.
authors.forename: Sven
authors.initials: S
authors.lastname: Kunkel
authors.affiliation: Department of Ray Last Anatomy Laboratory, University of Adelaide, Adelaide, New South Wales, Australia.
authors.forename: Wesley
authors.initials: W
authors.lastname: Fisk
mesh_terms: D000402:Airway Obstruction / Q000175:diagnosis*; D002102:Cadaver; D019296:Capnography / Q000379:methods / Q000592:standards*; D006801:Humans; D007442:Intubation, Intratracheal; D010366:Peak Expiratory Flow Rate; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods*
keywords: Airway; Resuscitation, Training